Is cervical decompression beneficial in patients with coexistent cervical stenosis and multiple sclerosis?

Cervical spinal stenosis (CS) and multiple sclerosis (MS) are two common conditions with distinctive pathophysiology but overlapping clinical manifestations. The uncertainty involved in attributing worsening symptoms to CS in patients with MS due to extremely high prevalence of asymptomatic radiological CS makes treatment decisions challenging. A retrospective review was performed analyzing the medical records of all patients with confirmed diagnosis of MS who had coexistent CS and underwent surgery for cervical radiculopathy/myeloradiculopathy. Eighteen patients with coexistent CS and MS who had undergone cervical spine decompression and fusion were identified. There were six men and 12 women with an average age of 52.7years (range 40-72years). Pre-operative symptoms included progressive myelopathy (14 patients), neck pain (seven patients), radiculopathy (five patients), and bladder dysfunction (seven patients). Thirteen of the 14 patients (92.9%) with myelopathy showed either improvement (4/14, 28.6%) or stabilization (9/14, 64.3%) in their symptoms with neck pain and radiculopathy improving in 100% and 80% of patients, respectively. None of the seven patients with urinary dysfunction had improvement in urinary symptoms after surgery.

Cervical spine decompression and fusion can improve or stabilize myelopathy, and significantly relieve neck pain and radiculopathy in the majority of patients with coexistent CS and MS. Urinary dysfunctions appear unlikely to improve after surgery. The low rate of surgical complications in this cohort demonstrates that cervical spine surgery can be safely performed in carefully selected patients with concomitant CS and MS with a good clinical outcome and also eliminate CS as a confounding factor in the long-term management of MS patients1

Anterior communicating artery aneurysm treatment The direction in which the fundus projects was chosen as the morphological criterion between endovascular and surgical methods. Proust et al. proposed that microsurgical clip application should be the preferred option in the treatment of ACoA aneurysms with anteriorly directed fundi and that endovascular packing be selected for those lesions […]

Fundus Lateral end of the internal auditory meatus, the wall of which is formed by the thin cribriform plate of bone separating the cochlea and vestibule from the internal acoustic meatus; a transverse crest divides the fundus into two regions; in the superior region are located the facial nerve area and the superior vestibular area; […]

UNC School of Medicine scientists led by Aravind Asokan, PhD, reveal how certain gene-carrying AAV vectors can penetrate the brain more efficiently to treat brain and spinal cord conditions, while reducing liver payload. Gene therapies promise to revolutionize the treatment of many diseases, including neurological diseases such as ALS. But the small viruses that […]

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A special program that involves balance and eye movement exercises may help people with multiple sclerosis (MS) with their balance problems and fatigue, according to a study. Balance problems and fatigue are common in MS and are tied to falls and limited mobility, which can affect people’s ability to work or participate in their daily […]

Study in mice identifies the molecular machinery responsible for dopamine release in the brain Studied for decades for its critical role in movement control and reward-seeking behaviors, the neurotransmitter dopamine has been the focus of numerous efforts to understand its activity, particularly when it goes awry in disorders such as Parkinson’s and addiction. While […]

How a group of forgotten players might help us make the game safer In 1987, National Football League players went on strike. As a response, NFL teams scrambled to fill their rosters with “replacement players,” individuals who had some experience with college or professional football, but who weren’t part of NFL rosters that year. Replacement […]

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Tickling the brain with low-intensity electrical stimulation in a specific area can improve verbal short-term memory. The researchers found word recall was enhanced with stimulation of the brain’s lateral temporal cortex, the regions on the sides of the head by the temples and ears. Patients recalled more words from a previously viewed list when low-amplitude […]